Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina · 2024
The comparison of erector spinae plane block and caudal block for postoperative analgesia in paediatric surgery - meta-analysis.
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Purnama Adhi Mahendratama, Hardian Rapto, Budiman Susatya Arif, Hanindito Elizeus, Utariani Arie
Аннотация
AIM: To assess the efficacy of Erector Spinae Plane Block (ESPB) compared to caudal block in reducing postoperative pain in paediatric surgery.
METHODS: An electronic literature search was conducted using the Cochrane Library, PubMed, and Google Scholar databases, with data collected from January 2018 until September 2023. This meta-analysis includes English-language randomized controlled trials (RCTs) studies contrasting ESPB with caudal block in paediatric patients. The primary outcome was the 24-hour post-operative pain scores. The secondary outcome included the time to rescue analgesia, the number of patients requiring rescue analgesia, and the occurrence of post-operative nausea and vomiting (PONV) and urinary retention.
RESULTS: Five RCTs with 295 samples were included. The results showed no significant difference between ESPB and caudal block in postoperative pain scores at 1st hour SMD (standardized mean difference) of -0.17 (95% CI -0.70, 0.36; I2=76%; p= 0.53), 2nd hour of SMD: -0.50 (95% CI -1.21, 0.21; I2=88%; p=0.17), 6th hour SMD -1.09 (95% CI -2.21, 0.03; I2=95%; p = 0.06), 12th hour SMD -0.77 (95% CI -1.75, 0.21; I2=93%; p=0.12), and the 24th hour SMD -0.13 (95% CI -0.39, 0.12;, I2=2%; p=0.30) were found. Furthermore, there was no significant difference in the time first to rescue analgesia, the number of patients requiring analgesia rescue, PONV occurrence, and urinary retention.
CONCLUSION: ESPB and caudal block showed equivalent analgesia efficacy and safety in paediatric surgery.
METHODS: An electronic literature search was conducted using the Cochrane Library, PubMed, and Google Scholar databases, with data collected from January 2018 until September 2023. This meta-analysis includes English-language randomized controlled trials (RCTs) studies contrasting ESPB with caudal block in paediatric patients. The primary outcome was the 24-hour post-operative pain scores. The secondary outcome included the time to rescue analgesia, the number of patients requiring rescue analgesia, and the occurrence of post-operative nausea and vomiting (PONV) and urinary retention.
RESULTS: Five RCTs with 295 samples were included. The results showed no significant difference between ESPB and caudal block in postoperative pain scores at 1st hour SMD (standardized mean difference) of -0.17 (95% CI -0.70, 0.36; I2=76%; p= 0.53), 2nd hour of SMD: -0.50 (95% CI -1.21, 0.21; I2=88%; p=0.17), 6th hour SMD -1.09 (95% CI -2.21, 0.03; I2=95%; p = 0.06), 12th hour SMD -0.77 (95% CI -1.75, 0.21; I2=93%; p=0.12), and the 24th hour SMD -0.13 (95% CI -0.39, 0.12;, I2=2%; p=0.30) were found. Furthermore, there was no significant difference in the time first to rescue analgesia, the number of patients requiring analgesia rescue, PONV occurrence, and urinary retention.
CONCLUSION: ESPB and caudal block showed equivalent analgesia efficacy and safety in paediatric surgery.